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Impact of a pharmacist-prepared interim residential care medication administration chart on gaps in continuity of medication management after discharge from hospital to residential care: a prospective pre- and post-intervention study (MedGap Study) Rohan A Elliott,1,2 Tim Tran,1 Simone E Taylor,1 Penelope A Harvey,3 Mary K Belfrage,4 Rhonda J Jennings,3 Jennifer L Marriott2
To cite: Elliott RA, Tran T, Taylor SE, et al. Impact of a pharmacist-prepared interim residential care medication administration chart on gaps in continuity of medication management after discharge from hospital to residential care: a prospective pre- and post-intervention study (MedGap Study). BMJ Open 2012;2:e000918. doi:10. 1136/bmjopen-2012-000918 < Prepublication history for
this paper is available online. To view this file please visit the journal online (http://dx. doi.org/10.1136/ bmjopen-2012-000918). For author footnote see end of the article. Received 2 February 2012 Accepted 10 April 2012 This final article is available for use under the terms of the Creative Commons Attribution Non-Commercial 2.0 Licence; see http://bmjopen.bmj.com
For numbered affiliations see end of article. Correspondence to Rohan A Elliott; rohan.
[email protected]
ABSTRACT Objectives: To test the impact of a hospital
ARTICLE SUMMARY
pharmacist-prepared interim residential care medication administration chart (IRCMAC) on medication administration errors and use of locum medical services after discharge from hospital to residential care. Design: Prospective pre-intervention and postintervention study. Setting: One major acute care hospital and one subacute aged-care hospital; 128 residential care facilities (RCF) in Victoria, Australia. Participants: 428 patients (median age 84 years, IQR 79e88) discharged to a RCF from an inpatient ward over two 12-week periods. Intervention: Seven-day IRCMAC auto-populated with patient and medication data from the hospitals’ pharmacy dispensing software, completed and signed by a hospital pharmacist and sent with the patient to the RCF.
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Key messages -
Primary and secondary outcome measures: Primary end points were the proportion of patients with one or more missed or significantly delayed (>50% of prescribed dose interval) medication doses, and the proportion of patients whose RCF medication chart was written by a locum doctor, in the 24 h after discharge. Secondary end points included RCF staff and general practitioners’ opinions about the IRCMAC. Results: The number of patients who experienced one or more missed or delayed doses fell from 37/202 (18.3%) to 6/226 (2.7%) (difference in percentages 15.6%, 95% CI 9.5% to 21.9%, p
